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Healing our troubled vets

Suicide, homelessness, stress disorders -- caring for today's veterans will be a long-term and costly commitment.

November 11, 2009

The public is kinder to its veterans today than it was during the Vietnam War, when soldiers risked their lives overseas only to face scorn from antiwar activists when they got home. Yet veterans of the conflicts in Iraq and Afghanistan may be having a harder time readjusting to civilian life than previous generations of warriors.

Recognition and treatment of combat- related mental health problems have greatly improved over the years, so it's impossible to compare historical rates of, say, post-traumatic stress disorder. But the statistics that do exist are troubling. Military suicides are soaring -- last year, the Army reported a record 133, and the suicide rate among soldiers in Iraq is 11% higher than in Vietnam. A Rand Corp. study last year found that almost 20% of Iraq and Afghanistan veterans report PTSD or depression. And homelessness may be on the rise; a report from Iraq and Afghanistan Veterans of America suggests that Vietnam vets who became homeless didn't end up on the streets until, on average, five to 10 years after they returned to the United States, while veterans of today's conflicts are turning up in shelters 18 months after leaving the service.

It doesn't help that soldiers are coming home in the midst of a recession. High rents and a lack of job prospects can send those already struggling to cope with war-related stress over the edge. But the likeliest explanation for these troublesome trends is that the military is stretched too thin. In order to fight two Middle Eastern wars, troops have been forced to serve multiple deployments, and reservists who thought their combat days were over have found themselves on the front lines.

As Defense Secretary Robert M. Gates pointed out last month at a mental health summit held by the Department of Veterans Affairs, the war in Afghanistan has surpassed the Revolutionary War as the longest conflict ever fought by this country with an all-volunteer force. The resulting strains have been cited as a factor in last week's shooting rampage at Ft. Hood, Texas, though it's too early to tell whether institutional stresses, cultural conflicts or personal demons caused the suspected killer, an Army psychiatrist, to snap. What's clear is that neither the men and women fighting in Iraq and Afghanistan, nor the American people as a whole, will be finished paying the cost of these wars even after the last U.S. soldier has left. Treating their invisible wounds -- mental disorders, substance abuse and traumatic brain injuries -- will take many decades.

To their credit, the Defense Department and the VA are increasingly recognizing this. Last week, Veterans Affairs Secretary Eric K. Shinseki laid out an ambitious plan to end homelessness among veterans, mostly by improving medical services, including mental health care. The Pentagon has nearly doubled its budget for psychological and brain-injury treatments over the past year and created a new program, Real Warriors, aimed at reducing the stigma many soldiers feel in seeking treatment for PTSD.

And yet so much more needs to be done. A report released earlier this year by the VA estimated that more than 130,000 veterans were homeless in January 2008. According to the National Alliance to End Homelessness, the VA's figures mean that veterans were more than twice as likely to be left homeless as the typical American. By far the largest number of homeless vets was in California, with an estimated 20,000 in Los Angeles alone. But advocates say California, like many other states, has no strategy for dealing with this problem, which is exacerbated by the region's elevated unemployment rate and high cost of housing.

In a glimmer of good news, Shinseki announced last week a groundbreaking agreement with two nonprofit groups in Los Angeles -- affordable housing developer A Community of Friends and New Directions, which provides housing, outpatient and residential treatment services to veterans -- to allow two buildings at the Sepulveda VA center in North Hills to be converted into a housing and treatment complex for veterans only. Executives at the two groups say it's the first time the VA has dedicated property to housing for needy veterans.

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